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<table width="535" border="0" cellspacing="0" cellpadding="0">
  <tr>
    <td height="48" colspan="6" style="padding-bottom:20px 0px; background:#69F; padding-left:10px; font-size: 24px;">Đăng ký thành viên</td>
    <td width="97">&nbsp;</td>
  </tr>
  <tr>
    <td width="27" height="38">&nbsp;</td>
    <td colspan="6"style="font-style: italic; font-weight: bold; font-size: 18px; color: #FFF; background-color: #90F; border-left-color: #FFF; border-bottom-color: #FFF; border-right-color: #FFF; border-top-color: #F00; border-top-style: solid; border-top-width: 3px; margin-top: -10px;">Thông tin đăng nhập</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td width="143" class="text_reg">Tên Đăng nhập(<span style="color:#F00">*</span>)</td>
   <td colspan="2" class="text_input"> <input class="text_input" name="txt_ten_dang_nhap" type="text" size="30" maxlength="50" /></td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td class="text_reg">Mật Khẩu</td>
    <td colspan="4"><input class="text_input" name="txt_mat_khau" type="text" size="30" maxlength="50" /></td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td class="text_reg">Nhập lại mật khẩu</td>
    <td colspan="4"><input class="text_input" name="txt_nhap_lai_mat_khau" type="text" size="30" maxlength="50" /></td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td class="text_reg">Địa chỉ email</td>
    <td colspan="4"><input class="text_input" name="txt_email" type="text" size="30" maxlength="50" /></td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td class="text_reg">Nhập Lại Địa chỉ email</td>
    <td colspan="4"><input class="text_input" name="txt_nhap_lai_email" type="text" size="30" maxlength="50" /></td>
  </tr>
  <tr>
    <td width="27" height="38">&nbsp;</td>
    <td colspan="6" style="font-style: italic; font-weight: bold; font-size: 18px; color: #FFF; background-color: #90F; border-left-color: #FFF; border-bottom-color: #FFF; border-right-color: #FFF; border-top-color: #F00; border-top-style: solid; border-top-width: 3px; margin-top: -10px;">Thông tin khách hàng</td>
  </tr>
  <tr>
    <td height="27" colspan="2">&nbsp;</td>
    <td class="text_reg">Họ và Tên(<span style="color:#F00">*</span>)</td>
    <td colspan="4"><input class="text_input" name="txt_ten_khach_hang" type="text" size="30" maxlength="50" /></td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td class="text_reg">Giới Tính(<span style="color:#F00">*</span>)</td>
    <td colspan="4"><input name="rad_nam" type="radio" value="Nam" />
      Nam
        <input name="rad_nu" type="radio" value="N&#7919;" />
        Nữ&nbsp;</td>
  </tr>
  <tr >
    <td height="39" colspan="2">&nbsp;</td>
    <td class="text_reg">Ngày Sinh(<span style="color:#F00">*</span>)</td>
    <td width="97" style="vertical-align:middle;" >
    Ngày 
      <select style="position:fixed;width:50px" name="ngay" id="ngay" onmouseover="this.size=5;" onmouseout="this.size=1;">
</select> 
</td>
<td width="97" style="vertical-align:middle;">
      Tháng 
      <select  style="position:fixed;width:50px" name="ngay2" id="thang"  onmouseover="this.size=5;" onmouseout="this.size=1;" >
      </select> 
    </td>
    <td colspan="2" style="vertical-align:middle;">
      Năm
      <select style="position:fixed;width:70px;"  name="ngay3" id="nam"  onmouseover="this.size=5;" onmouseout="this.size=1;">
      </select></td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td class="text_reg">Điện Thoại(<span style="color:#F00">*</span>)</td>
    <td colspan="4">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td class="text_reg">Thành Phố(<span style="color:#F00">*</span>)</td>
    <td colspan="4">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2">&nbsp;</td>
    <td class="text_reg">&nbsp;</td>
    <td colspan="4">&nbsp;</td>
  </tr>
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